| NPI | 1821021940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 39773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 44756) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2009-02-16 |