| NPI | 1265676043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1749) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS11827) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2013-03-01 |