| NPI | 1205097375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101249870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D79880) |
| 207P00000X Emergency Medicine (Licence: DC MD044502) | |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2017-08-08 |