| NPI | 1730367301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 52519-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 37461) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2011-07-25 |