| NPI | 1184759029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.025714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 23313) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2018-07-05 |