| NPI | 1912156084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 03350) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2013-12-24 |