| NPI | 1528049517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 33051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101056751) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-01-28 |