| NPI | 1235335365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC MDO.1500 DO) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017164) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2012-07-18 |