| NPI | 1235339383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101244002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-1947) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2016-05-12 |