| NPI | 1134210537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN DO0000002066) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016124) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-03-04 |