| NPI | 1982680310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 16326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD31299) |
| 207P00000X Emergency Medicine (Licence: GA 038535) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2022-12-28 |