| NPI | 1891741252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 41538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2005024056) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-11-15 |