| NPI | 1538397864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS15927) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018362) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-03-20 |