| NPI | 1174510218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 18656) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2002027887) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2018-11-06 |