| NPI | 1336253814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-01159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A89379) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-10-18 |