| NPI | 1538133830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME86795) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 36335) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-10-31 |