| NPI | 1174728372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301116733) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 50209) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-08-06 |