| NPI | 1982651824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-29487) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD15648) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-11-05 |