| NPI | 1295961332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 38612) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD435502) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2020-10-29 |