| NPI | 1013995547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME118552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD17640) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2019-12-05 |