| NPI | 1386681336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD28876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M6487) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2017-09-06 |