| NPI | 1871828764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D78294) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R71444) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2014-08-06 |