| NPI | 1336351246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 48308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 8419A) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2011-06-30 |