| NPI | 1952366437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 050514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 246115) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-09-06 |