| NPI | 1235350513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 61664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2008-00003) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-18 |