| NPI | 1316372956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101052137) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: DC MD035177) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |