| NPI | 1952537755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 240886) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D73950) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2012-04-12 |