| NPI | 1356585350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 14388) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 45589) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2012-07-16 |