| NPI | 1790987683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200300672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 18554) |
| 207P00000X Emergency Medicine (Licence: MI 4301091476) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2016-04-28 |