| NPI | 1700922630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD T4326) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 048159) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-03-16 |