| NPI | 1619929007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200300369) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 054584) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |