| NPI | 1891792719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS009480L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 0728) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2008-11-11 |