| NPI | 1013137280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 15568) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 30400) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2014-10-29 |