| NPI | 1558388199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101230069) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 37406) |
| 207P00000X Emergency Medicine (Licence: LA 12159R) | |
| 207P00000X Emergency Medicine (Licence: IL 36093838) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-11-23 |