| NPI | 1356599211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 17237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 52081) |
| 207P00000X Emergency Medicine (Licence: CA 20A11709) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2015-08-27 |