| NPI | 1760455455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 61383) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 1427) |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2013-10-04 |