| NPI | 1881718666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 18754) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101241215) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2014-12-16 |