| NPI | 1588892590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 35597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2009015750) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2014-02-12 |