| NPI | 1700983459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200700348) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 023220) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2007-07-08 |