| NPI | 1114993995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 02997) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA DO.022063) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2018-02-16 |