| NPI | 1588855514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101025382) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2005-01068) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2012-03-28 |