| NPI | 1336116607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.02213) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 22113) |
| Enumeration Date | 2006-03-04 |
| Last Update Date | 2010-07-13 |