| NPI | 1124054929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 054094) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01070687A) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-11-05 |