| NPI | 1720185549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA LIMITED) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101102751) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-05-20 |