| NPI | 1629269279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME160602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 44414) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2023-03-02 |