| NPI | 1265449516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 117870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR R-4011) |
| 207P00000X Emergency Medicine (Licence: LA 18504) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-06-29 |