| NPI | 1538214069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 014311) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: LA 014311) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-08-03 |