| NPI | 1528263548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D69223) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 11162) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2009-11-03 |