| NPI | 1932498011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D78852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD042850) |
| 207P00000X Emergency Medicine (Licence: CA 135519) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2015-07-27 |