| NPI | 1265459861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102-037036) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 00-36265) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-05-30 |