| NPI | 1992793251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 19372) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00025767) |
| 207P00000X Emergency Medicine (Licence: TN 41139) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2008-01-25 |