| NPI | 1043326366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA a73898) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A73898) |
| 174H00000X Health Educator (Licence: CA A73989) | |
| 207R00000X Internal Medicine (Licence: CA A73989) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-07-17 |