| NPI | 1669460515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD S0050410) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101054572) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2008-06-11 |