| NPI | 1376806455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 74137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101262) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2015-06-24 |