| NPI | 1063491272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 45174) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME94785) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2018-05-07 |