| NPI | 1225113210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 040929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 14208) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-09-30 |