| NPI | 1124093257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME113843) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 048023) |
| 207P00000X Emergency Medicine (Licence: WY 7719A) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-10-18 |