| NPI | 1073509618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 23763) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 054071) |
| 207P00000X Emergency Medicine (Licence: FL ME86389) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2010-03-30 |