| NPI | 1235373093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204063) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 22510) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2013-04-16 |