| NPI | 1265589089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 28369) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 21091) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-09-13 |