| NPI | 1215999347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200601041) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 38470) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2011-01-18 |