| NPI | 1457445181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 5561A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 180239-1204) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |