| NPI | 1538384789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00096) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 36664) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2016-03-11 |