| NPI | 1679526453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS9524) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H61923) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2015-04-14 |