| NPI | 1427360312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME115521) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301096707) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2014-03-25 |