| NPI | 1225341530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 32890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 49986) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2018-08-29 |