| NPI | 1487739512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME96922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 057802) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2010-08-13 |