| NPI | 1508858333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2012-02340) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 22949) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2013-07-05 |