| NPI | 1679598056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101037888) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 42810) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-05-30 |