| NPI | 1821216151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 13960) |
| Additional Taxonomies | 207PH0002X Emergency Medicine Hospice and Palliative Medicine (Licence: PR 13960) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2011-12-01 |