| NPI | 1508086638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 038676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C38713) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |