| NPI | 1679527766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D-0065055) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD068839L) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2010-09-27 |