| NPI | 1407907389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 58826) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO1082) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-06-03 |