| NPI | 1508969825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49111) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200500237) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2012-12-04 |