| NPI | 1427258896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.202472) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME122599) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2018-09-07 |