| NPI | 1497151997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME145333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 19236) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2020-08-07 |