| NPI | 1639332273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO1446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 20491) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2017-04-19 |