| NPI | 1871567842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME95596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 055471) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-02-07 |