| NPI | 1487649273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 40883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101229635) |
| Enumeration Date | 2005-09-17 |
| Last Update Date | 2012-07-12 |