| NPI | 1083978142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301100995) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5315055665) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |