| NPI | 1134168420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 18244) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME69500) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-08-21 |