| NPI | 1467402800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 35466) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD4625) |
| 207P00000X Emergency Medicine (Licence: CA G36840) | |
| 207P00000X Emergency Medicine (Licence: MO 2015039936) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2018-10-25 |