| NPI | 1922262013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 51580-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME122097) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2015-01-07 |