| NPI | 1457333858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 63585) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME63585) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2020-10-19 |