| NPI | 1174963987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 29010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7053) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2018-04-19 |