| NPI | 1629311121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 006346) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: GA 006346) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2016-03-10 |