| NPI | 1124132386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 046053) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101236067) |
| 207P00000X Emergency Medicine (Licence: NC 200301097) | |
| 207P00000X Emergency Medicine (Licence: LA 15230R) | |
| 207P00000X Emergency Medicine (Licence: AL MD.25283) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-12-04 |