| NPI | 1588834063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7633661-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 81889) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2016-01-07 |