| NPI | 1043298599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101009952) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102202244) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2012-02-27 |