| NPI | 1023117660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102202343) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 994) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-11-17 |