| NPI | 1417919762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 4481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L8642) |
| 207P00000X Emergency Medicine (Licence: ME 1927) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-10-24 |