| NPI | 1578546883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 29070) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101226848) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2008-04-28 |