| NPI | 1306893359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD175591) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 2004-0116) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2017-09-06 |