| NPI | 1568498111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200300147) |
| 207P00000X Emergency Medicine (Licence: MI 5101011933) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2016-10-26 |