| NPI | 1467724054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101254694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME160133) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2023-09-12 |