| NPI | 1164465704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.020857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 020857) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-11-08 |