| NPI | 1558528653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2245) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01065414A) |
| 207P00000X Emergency Medicine (Licence: IL 125051260) | |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2009-07-24 |