| NPI | 1063487635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL os8587) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 1404) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-10-05 |