| NPI | 1285715649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS9991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 58404) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-03-30 |