| NPI | 1750383105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NE 255) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 255) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2018-07-17 |