| NPI | 1558672865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 790L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 22536) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2014-01-07 |