| NPI | 1477515369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9400906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01042330A) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-07-06 |