| NPI | 1861606121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204805) |
| Additional Taxonomies | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: PA MT189443) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2016-08-17 |