| NPI | 1083848808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 30422) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 77803) |
| 207P00000X Emergency Medicine (Licence: MS 24735) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2017-04-27 |