| NPI | 1902079551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0076785) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2011-01925) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2014-01-07 |