| NPI | 1972598506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6068769-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 045167) |
| 207P00000X Emergency Medicine (Licence: MS 13154) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2009-07-09 |