| NPI | 1972872703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-13914) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 119791) |
| 207L00000X Anesthesiology (Licence: IA R-9718) | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2021-05-05 |