| NPI | 1932362340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A121249) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 050281) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2012-12-08 |