| NPI | 1083723134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 25500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 17434) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-12-13 |