| NPI | 1992795496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 26380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 17333) |
| 207P00000X Emergency Medicine (Licence: KY 24972) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |