| NPI | 1043496979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 065699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2010-00294) |
| 207P00000X Emergency Medicine (Licence: GA 65699) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2012-12-05 |