| NPI | 1700830726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 35434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0084558) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-09-24 |