| NPI | 1457580441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 250524) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094925) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2012-11-13 |