| NPI | 1124121348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 79208) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME142605) |
| 207P00000X Emergency Medicine (Licence: NC 200300863) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-05-05 |