| NPI | 1386890622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-13250) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 233715) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2017-12-13 |