| NPI | 1497775076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D70146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 061413) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-07-09 |