| NPI | 1316168966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2010010433) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-34384) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-07-31 |