| NPI | 1689869265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E6003) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102202336) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2012-08-30 |