| NPI | 1376748947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 2141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2009-01571) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2013-04-10 |