| NPI | 1639350655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101242183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D76277) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2013-09-23 |