| NPI | 1205194578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A122861) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-1887) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2017-08-17 |