| NPI | 1639156490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 021700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 21700) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-08-11 |