| NPI | 1942225305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2005029371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME85875) |
| 207P00000X Emergency Medicine (Licence: GA 051440) | |
| 207P00000X Emergency Medicine (Licence: PA MD071774L) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2011-02-28 |