| NPI | 1760529523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 53772) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 041812) |
| 207P00000X Emergency Medicine (Licence: IA 38440) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2013-10-06 |