| NPI | 1396939781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E5477) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2009-0093) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2016-03-14 |