| NPI | 1457396434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME115640) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 040781) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2019-08-15 |