| NPI | 1851618318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013014822) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0436434) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2014-02-25 |