| NPI | 1457738353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME140123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 303640) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2019-07-03 |