| NPI | 1336224799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GU M-1725) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD.200714) |
| 207P00000X Emergency Medicine (Licence: LA 200714) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-03-08 |