| NPI | 1114942661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101-221490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 022271) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-05-30 |