| NPI | 1033465547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD19255) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101012) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2018-04-23 |