| NPI | 1205842309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 63781) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 27021) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-04-06 |