| NPI | 1851596134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 235511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 103100) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2011-03-25 |