| NPI | 1295899250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 23032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2000-01307) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2009-05-15 |