| NPI | 1346258233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301051601) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD433073) |
| 207P00000X Emergency Medicine (Licence: VA 0101243662) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2015-07-10 |