| NPI | 1700967262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.200970) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200970) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-10-20 |