| NPI | 1962439695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 11616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 230239) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-06-17 |