| NPI | 1588827422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2009016633) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016380) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-06-20 |