| NPI | 1851501183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 064860) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 64860) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-09-11 |