| NPI | 1548295249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD183619)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID TL3776)  | 
| Enumeration Date | 2006-07-11 | 
| Last Update Date | 2018-01-23 |