| NPI | 1396965190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 005322) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017061) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2009-12-07 |