| NPI | 1659533792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 018886) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092812) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2012-09-05 |