| NPI | 1538429360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2016007945) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019664) |
| Enumeration Date | 2012-05-27 |
| Last Update Date | 2017-10-27 |