| NPI | 1477610434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 51134-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301099122) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2017-03-31 |