| NPI | 1073706081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME101864) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A93453) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2008-12-06 |