| NPI | 1073710075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 14439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 046138) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2009-10-21 |