| NPI | 1083660245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD29012) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 27797) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2013-03-18 |