| NPI | 1376635334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 00019307) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 056274) |
| 207P00000X Emergency Medicine (Licence: GA 056274) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-10-14 |