| NPI | 1437174307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD28003) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD425791) |
| 207P00000X Emergency Medicine (Licence: WA 60476107) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-11-25 |