| NPI | 1144367780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2011-01895) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 158763) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2012-08-09 |