| NPI | 1376755181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 716396-8905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101244919) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-02-15 |