| NPI | 1164470951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9800907) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC SC0659) |
| 207P00000X Emergency Medicine (Licence: FL OS0007075) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-10-06 |