| NPI | 1437316411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 110030) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN12160) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2011-08-17 |