| NPI | 1235111477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 118390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00025819) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2023-03-07 |