| NPI | 1699931808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 37013) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0081911) |
| 207P00000X Emergency Medicine (Licence: VA 0101249753) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2018-08-23 |