| NPI | 1851558084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 15631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G55870) |
| 207P00000X Emergency Medicine (Licence: CO 38250) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2012-05-21 |