| NPI | 1386831170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: DC MD17840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0034841) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2007-09-26 |