| NPI | 1679577035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 15365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2010-02060) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2011-08-09 |