| NPI | 1700931524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD15352R) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 15352R) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2009-10-19 |