| NPI | 1467492769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 21005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 13982) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-16 |