| NPI | 1053528844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-7814) |
| 207P00000X Emergency Medicine (Licence: TX N1766) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-09-28 |