| NPI | 1467439794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD10660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0021462) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2011-01-14 |