| NPI | 1215131289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 97-00343) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 044548) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2013-11-21 |