| NPI | 1255374781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.07341R) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA H4982) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2008-10-29 |