| NPI | 1154385086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD 03952) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 31461) |
| 207P00000X Emergency Medicine (Licence: MD D0067329) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2011-09-26 |