| NPI | 1194804427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 025554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 025554) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |