| NPI | 1942237086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME114894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 3684189) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-04-06 |