| NPI | 1487662276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 1366) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101014409) |
| 207P00000X Emergency Medicine (Licence: WA OP0002216) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2013-03-30 |