| NPI | 1154596773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102203628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC NC-2012-00587) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2013-12-18 |