| NPI | 1053393637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 56231) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: GA 56231) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |