| NPI | 1811334535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME126805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL35735) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2016-06-27 |