| NPI | 1588691190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6740351-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 3919) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2016-08-29 |