| NPI | 1154355287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 012225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 07848) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-01-21 |