| NPI | 1003805268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 41087) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301095514) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2016-09-19 |