| NPI | 1457641342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-0903) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO167057) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2016-01-27 |