| NPI | 1962406769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 28346) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 053271) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-10-18 |