| NPI | 1467654566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 39476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2009001615) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA 39476) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-05-11 |