| NPI | 1083608640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301074810) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 216959) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2012-04-19 |