| NPI | 1871533992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2001-00052) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME88851) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-05-13 |