| NPI | 1184063067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD21027) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301103627) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2016-07-18 |