| NPI | 1306828702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 417779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 35126) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2009-10-21 |