| NPI | 1083637839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 0021021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-8583) |
| 207P00000X Emergency Medicine (Licence: CA G87581) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-08-22 |