| NPI | 1487713343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD27914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 10679R) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2015-05-20 |