| NPI | 1922323450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.205126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 23379) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2014-12-17 |