| NPI | 1871766998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301077997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301077997) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |