| NPI | 1043573207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 304424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101255) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-03-29 |