| NPI | 1508898636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD015969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 015969) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-09-10 |