| NPI | 1891894838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME103889) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 054315) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2009-12-22 |