| NPI | 1003179151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015014472) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO BJH2012017417) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2016-02-18 |