| NPI | 1144200429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 28203) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 12241) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2019-02-12 |