| NPI | 1649253725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 000525) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 208715) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-05-13 |