| NPI | 1508970815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 73694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 430162281) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-08-19 |