| NPI | 1982847414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME 112510) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-08-16 |