| NPI | 1265400485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 19264) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 25109) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2013-12-02 |