| NPI | 1992774731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME68507) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 15687) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2019-10-17 |