| NPI | 1730491556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 21813) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-2303) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2015-12-16 |