| NPI | 1124068325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI DOS911) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-08-04 |