| NPI | 1245342013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME112038) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 0019156) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-02-07 |