| NPI | 1144251182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD200010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD20010) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-02-06 |