| NPI | 1023339017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 35405) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 15339) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2013-07-31 |