| NPI | 1932157591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 13674) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 29085) |
| 207P00000X Emergency Medicine (Licence: NC 200000129) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-08 |