| NPI | 1043504277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 073490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019230) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2015-06-11 |