| NPI | 1861419335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101038302) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 22709) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-02-19 |