| NPI | 1669417200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME71708) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00018957) |
| 207P00000X Emergency Medicine (Licence: NC 9601750) | |
| 207P00000X Emergency Medicine (Licence: GA 057259) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2007-07-08 |