| NPI | 1366622516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 100729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116017553) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2018-07-17 |