| NPI | 1871559559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-2789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D58946) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2015-03-04 |