| NPI | 1336450162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301104446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 6345) |
| 207P00000X Emergency Medicine (Licence: FL ME 116557) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2019-05-16 |