| NPI | 1104039940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD28221) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 046156) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-07-18 |