| NPI | 1376653790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO159936) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT 8382) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-06-28 |