| NPI | 1346354453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 055121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN4417) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-09 |