| NPI | 1194783191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-01562) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS012191) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2008-07-23 |