| NPI | 1811960578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME98976) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 21484) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2010-08-25 |