| NPI | 1669577052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00220) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 230273) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-11-29 |