| NPI | 1730104852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 24413) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 24414) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-02-03 |