| NPI | 1154494805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0043572) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 28613) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2015-12-01 |