| NPI | 1174591739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME64437) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME64437) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-05-12 |