| NPI | 1366738965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS13269) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013935) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2015-08-26 |