| NPI | 1265428890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME70565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 056292) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2024-09-30 |