| NPI | 1184912867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 47680) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R72768) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2014-06-18 |