| NPI | 1578508149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0060545) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301098748) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2013-11-22 |