| NPI | 1942261318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 28495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 28495) |
| 207P00000X Emergency Medicine (Licence: NE 18304) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2008-02-19 |