| NPI | 1649310541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200400495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS 10349) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-06-30 |