| NPI | 1386961167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 63050) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME114893) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2022-01-11 |