| NPI | 1043394232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102201323) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-01-30 |