| NPI | 1851680029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 072709) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS015450) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2014-08-28 |