| NPI | 1427251008 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 7561)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 24331)  | 
| Enumeration Date | 2007-06-09 | 
| Last Update Date | 2017-03-17 |