| NPI | 1417198490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 22566) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.203905) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2018-03-19 |