| NPI | 1689933327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME125521) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101255361) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2018-04-30 |