| NPI | 1043278963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0013634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 223736) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-09-07 |