| NPI | 1689870917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 062962) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN11378) |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2012-09-11 |