| NPI | 1902972102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME60407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR C5919) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-12-15 |