| NPI | 1124162730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD20741) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0037159) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-11-27 |