| NPI | 1316197775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ residency) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 51318) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 62764) | |
| 207P00000X Emergency Medicine (Licence: AZ 43906) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-11-11 |