| NPI | 1275852832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 39934) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-8844) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2013-06-12 |