| NPI | 1891927455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 019752) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 019752) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2012-04-04 |