| NPI | 1174655740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-10699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 29026) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2015-09-25 |