| NPI | 1013228329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS T-2302) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 21838) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2013-06-23 |