| NPI | 1326027822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 051319) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 39125) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-11-29 |