| NPI | 1427375260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013017023) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 24842) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2013-10-31 |