| NPI | 1174575203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME98688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 55999) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-03-07 |