| NPI | 1265591002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME96811) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 058522) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2008-04-25 |