| NPI | 1306092713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101259336) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD044808) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2019-02-25 |