| NPI | 1376604355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101243475) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT184663) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2018-10-11 |