| NPI | 1194012807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301099350) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.207280) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2016-02-16 |