| NPI | 1518097096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME106213) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2008-00796) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-05-28 |