| NPI | 1366419137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0082274) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 049114) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2007-07-09 |