| NPI | 1235193160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2004-01100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 27182) |
| 207P00000X Emergency Medicine (Licence: CA A94685) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2011-12-15 |