| NPI | 1649400227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 65012) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094937) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2016-10-11 |