| NPI | 1033371893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 54628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 247473) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2016-06-28 |