| NPI | 1730106287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2000173366) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 0000031495) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-11-12 |