| NPI | 1003949330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101243613) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD436552) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-11-02 |