| NPI | 1427345073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P9323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301098967) |
| 207P00000X Emergency Medicine (Licence: OK 30552) | |
| 207P00000X Emergency Medicine (Licence: IN 01081325A) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2019-12-09 |