| NPI | 1821067984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 25774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS5630) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2014-04-10 |