| NPI | 1982732244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2004-00774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 30538) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-10-15 |