| NPI | 1154405033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD036932) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2002-00951) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-04-21 |