| NPI | 1154525970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD151252) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R8251) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-05-17 |