| NPI | 1568487981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101027071) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC 8129) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2011-06-16 |