| NPI | 1669662433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-00602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101243033) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2018-08-02 |