| NPI | 1265486864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME99543) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI CMD12095) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-07-10 |