| NPI | 1477840445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 62440-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019572) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2014-07-14 |