| NPI | 1154502029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 201914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.201914) |
| 207P00000X Emergency Medicine (Licence: LA MD. 201914) | |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2013-04-16 |