| NPI | 1134117955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A64062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M001471) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2012-04-10 |