| NPI | 1861436057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2006-0648) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.012608) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-07-08 |