| NPI | 1295751048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 40921) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200202) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-06-17 |