| NPI | 1669582656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 33039) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 21246) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-07-01 |