| NPI | 1962799460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-12361) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD180078) |
| 207P00000X Emergency Medicine (Licence: MI 4301099332) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2019-04-18 |