| NPI | 1043317712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 243626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A94070) |
| 207P00000X Emergency Medicine (Licence: CT 046462) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2010-07-12 |