| NPI | 1558347930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD32926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0058996) |
| 207P00000X Emergency Medicine (Licence: VA 010228867) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-07-08 |