| NPI | 1568626000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD16106) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092884) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2011-07-28 |