| NPI | 1699062240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 13190) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301098614) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2015-12-23 |