| NPI | 1407893027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD 10688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 35044) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-12-04 |