| NPI | 1134383003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 53119) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0071973) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-08-05 |