| NPI | 1861482523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 014843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101019618) |
| 207P00000X Emergency Medicine (Licence: PA MD042932E) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2013-01-04 |