| NPI | 1275662421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC TL30290) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD430713) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2009-01-23 |