| NPI | 1932187598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101015016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102202294) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2011-10-12 |