| NPI | 1043205669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME119322) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 049405) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2014-06-02 |