| NPI | 1366705444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R2303) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR pg158047) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2013-10-25 |