| NPI | 1093960825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD153985) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 7471569-1205) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2011-07-19 |