| NPI | 1972653715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 24220) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 37289) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2013-06-04 |