| NPI | 1346539905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.33314) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.33314) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2017-02-06 |