| NPI | 1629166137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 200060) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me98577) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2009-11-18 |