| NPI | 1487671079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 43240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 035358) |
| 207P00000X Emergency Medicine (Licence: IL 036-073733) | |
| 207P00000X Emergency Medicine (Licence: VA 0101-234978) | |
| 207P00000X Emergency Medicine (Licence: CT 040157) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-01-24 |