| NPI | 1326350521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 50172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 069993) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2013-08-16 |