| NPI | 1205094919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017589) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2019-05-29 |