| NPI | 1457585259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL TRN13445) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME116742) |
| 207P00000X Emergency Medicine (Licence: GA 068364) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2015-03-18 |