| NPI | 1962493676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 41834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 32688) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-07-14 |