| NPI | 1376593186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 038985) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-01-24 |