| NPI | 1477638005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 02981) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4350) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2009-08-14 |