| NPI | 1184850851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD041159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101253678) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2014-12-15 |