| NPI | 1194843367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 53062-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0097144) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2011-01-06 |