| NPI | 1952327892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102041280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS-006095-E) |
| 207P00000X Emergency Medicine (Licence: WV 1068) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |