| NPI | 1699777151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME104672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A98470) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2010-04-19 |