| NPI | 1033375654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101248234) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA MD440889) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2011-08-16 |