| NPI | 1720287600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 25328) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 5629) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-11-15 |