| NPI | 1083657266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200800784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 54620) |
| 207P00000X Emergency Medicine (Licence: OR MD26289) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-04-14 |