| NPI | 1750340808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 58164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 23186) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2013-06-19 |