| NPI | 1881637148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD191862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 11338) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-06-24 |