| NPI | 1255561866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME115973) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094830) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2013-05-24 |