| NPI | 1477878858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101018801) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2013-10-20 |