| NPI | 1194955435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A119758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT194943) |
| 207P00000X Emergency Medicine (Licence: PA MD-444601) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2014-11-29 |