| NPI | 1275734378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY TL1320) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4801) |
| 207P00000X Emergency Medicine (Licence: CO DR-51379) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2012-07-20 |