| NPI | 1669792685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013468) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2015-03-25 |