| NPI | 1487655361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 44098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101059155) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2009-04-21 |