| NPI | 1922237676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME113789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL31970) |
| 207P00000X Emergency Medicine (Licence: GA 75051) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2016-04-22 |