| NPI | 1891845681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME101939) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN10161) |
| 207P00000X Emergency Medicine (Licence: TX N6317) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-03-31 |