| NPI | 1033260955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME103463) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN10168) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2009-08-27 |