| NPI | 1154365518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 81596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 45339) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-04-17 |