| NPI | 1437160249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2015-00537) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 23786) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-09-30 |