| NPI | 1184760175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD22468) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101237114) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2018-10-11 |