| NPI | 1285651885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101229868) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC 6516) |
| 207P00000X Emergency Medicine (Licence: MD D16387) | |
| 207P00000X Emergency Medicine (Licence: NC 38204) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-09-18 |