| NPI | 1144277567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0012059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101034346) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2012-01-18 |