| NPI | 1285753079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 02909) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101011827) |
| 207P00000X Emergency Medicine (Licence: PA OS009539L) | |
| 207P00000X Emergency Medicine (Licence: IN 02001513A) | |
| 207P00000X Emergency Medicine (Licence: TN DO0000001714) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2015-08-04 |