| NPI | 1497735039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 16596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS0009111) |
| 207P00000X Emergency Medicine (Licence: TN DO0000001749) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2009-08-05 |