| NPI | 1518935626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2004001486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 30533) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |