| NPI | 1831108083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101242432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 23443) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-06-30 |