| NPI | 1477828739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME126222) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 252301) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2016-06-24 |