| NPI | 1013066844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 24055) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 5025) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |