| NPI | 1891845798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME101449) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 60790) |
| 207P00000X Emergency Medicine (Licence: FL TRN9208) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-11-17 |