| NPI | 1831282979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME39881) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME39881) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-12-02 |