| NPI | 1386667988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO CO32873) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 6433) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-03-25 |