| NPI | 1457558025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA RTP002364) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU DO0064) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2016-05-16 |