| NPI | 1861729725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 22675) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 206798) |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2016-07-25 |