| NPI | 1528019221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 25779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 12269) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-03-24 |