| NPI | 1154527547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD183581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-11238) |
| 207P00000X Emergency Medicine (Licence: NM RS20070377) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2017-09-12 |