| NPI | 1124411913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 19924) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 19924) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2016-03-04 |