| NPI | 1538315072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012020969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017953) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2013-03-01 |