| NPI | 1376707349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX n9200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R70585) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2016-05-23 |