| NPI | 1922025550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 42380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 047795) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-02-07 |