| NPI | 1518163658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11155) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017417) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2018-03-17 |