| NPI | 1346502143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME133862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 15782) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2020-02-18 |