| NPI | 1730389354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME109582) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 231841) |
| Enumeration Date | 2007-07-22 |
| Last Update Date | 2011-09-06 |