| NPI | 1235137274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME105917) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 042427) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2011-02-11 |