| NPI | 1295911865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.202240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA PGY.1.LSUN-EMED) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2011-12-07 |