| NPI | 1184871758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 12984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 51847) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2014-04-14 |