| NPI | 1447271481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17751) |
| 207P00000X Emergency Medicine (Licence: WI 65077) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2016-03-17 |