| NPI | 1609032093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MI 4301096726) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301096726) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2014-09-10 |