| NPI | 1144218223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME96436) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101035993) |
| 207P00000X Emergency Medicine (Licence: MD D0025832) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2008-01-14 |