| NPI | 1851775464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS15189) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO4706) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-03-26 |