| NPI | 1386661908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J7627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 22034) |
| 207P00000X Emergency Medicine (Licence: CA G74618) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-02-20 |