| NPI | 1487622890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 29564) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 40514) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2014-10-21 |