| NPI | 1063629830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6972290-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-7535) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-07-03 |