| NPI | 1518026020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD 21857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA VA 0101052330) |
| 207P00000X Emergency Medicine (Licence: MD D0051759) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |