| NPI | 1811941701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A54567) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI 10474) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-06-03 |