| NPI | 1518062249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS-6584) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3206) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2017-09-18 |