| NPI | 1700884343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101251601) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 10213) |
| 207P00000X Emergency Medicine (Licence: CA A79719) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2015-02-20 |