| NPI | 1356459010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6522771-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 35395) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-11-30 |