| NPI | 1407809866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 51160) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 51160) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-12-26 |