| NPI | 1538471339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 69897) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 570381) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-06-27 |