| NPI | 1932105988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 013102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 13102) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2014-04-30 |