| NPI | 1194166215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS14692) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 78417) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2018-03-01 |