| NPI | 1073698122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME99282) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 057936) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-12-02 |