| NPI | 1962440297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 19384) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004026421) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2013-12-26 |