| NPI | 1063490548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A806-85) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 18056) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2015-11-09 |