| NPI | 1962411009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2009-0234) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 227729) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2016-11-03 |