| NPI | 1841217445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101054008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D26276) |
| 207P00000X Emergency Medicine (Licence: PA MD-042681-E) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |