| NPI | 1184073165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 312700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN23800) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-07-29 |