| NPI | 1154566941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD040439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101253612) |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2017-01-13 |