| NPI | 1649477993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 061550) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2011033192) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-01-05 |