| NPI | 1376834812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0077325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD042071) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2014-06-10 |