| NPI | 1922026053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2005-00091) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME92949) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-08-11 |