| NPI | 1285845040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101242576) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR 390200000X) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2014-11-26 |