| NPI | 1457739757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 36830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 55989) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2018-07-05 |