| NPI | 1356420061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME104157) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN10152) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-05-14 |