| NPI | 1700173317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 9174) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 6473) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2014-07-22 |