| NPI | 1346447588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 3990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-8104) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2011-01-24 |