| NPI | 1467643494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.202841) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2009-00881) |
| 207P00000X Emergency Medicine (Licence: LA 202841) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2010-07-07 |