| NPI | 1003955048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 062385) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 2006-0369) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-07-30 |