| NPI | 1720118490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 50295) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 039436) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-09-03 |