| NPI | 1174795058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00754) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301085964) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2013-11-21 |