| NPI | 1003916156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 51561) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0096634) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-01-06 |