| NPI | 1134368939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 23952) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA DO.000229) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2018-08-25 |