| NPI | 1467441048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD172857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 6238A) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2015-08-10 |