| NPI | 1942298880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101057734) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0063247) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2008-02-28 |