| NPI | 1033153580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME36892) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 45395) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-10-07 |