| NPI | 1851335855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME83707) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 308613) |
| 207P00000X Emergency Medicine (Licence: NC 2018-00258) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-02-13 |