| NPI | 1629028196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS8663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS008280L) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-05-14 |