| NPI | 1932259827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 04041) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO1485) |
| 207P00000X Emergency Medicine (Licence: IL 036-122659) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2017-07-10 |