| NPI | 1861718249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D75751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 69010) |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2014-08-15 |