| NPI | 1639373103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME1110098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD 970591) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2011-09-29 |