| NPI | 1750368577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME109541) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9800317) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2012-09-26 |