| NPI | 1437297157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2010-01999) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102201851) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2011-03-08 |