| NPI | 1831113752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 3438) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WY 6917A) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SD 3438) | |
| 207R00000X Internal Medicine (Licence: SD 3438) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2010-02-09 |