| NPI | 1649295981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 226640) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116015100) |
| 207P00000X Emergency Medicine (Licence: VA 0101237216) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-05-06 |