| NPI | 1790731222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 016195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 09750) |
| 207P00000X Emergency Medicine (Licence: AL MD.27709) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2013-01-09 |