| NPI | 1659588762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 059207) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME154944) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-06-22 |