| NPI | 1184826265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 7547) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 7547) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PR 7547) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-07-08 |