| NPI | 1629183504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 31116) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 18807) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |