| NPI | 1164421590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 26998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200500266) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2011-08-09 |