| NPI | 1114901915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 56105-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 26998) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2012-03-04 |