| NPI | 1912103573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11399) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT011974) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2011-08-30 |