| NPI | 1063731693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV NV15050) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 46297) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2016-05-22 |