| NPI | 1275531477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0013666) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 036928) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-02-23 |