| NPI | 1700041886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 57145-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017770) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2013-08-22 |