| NPI | 1306164389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2015-02448) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2013-0132) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2016-03-08 |