| NPI | 1093941353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 078423) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME142575) |
| 207P00000X Emergency Medicine (Licence: NC 156760) | |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2020-03-30 |