| NPI | 1144421256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD151486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN11196) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2021-11-17 |