| NPI | 1851463244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 073374) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 005925) |
| 207P00000X Emergency Medicine (Licence: CA 20A 12351) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2015-02-10 |