| NPI | 1588640445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 11356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 17440) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-09 |