| NPI | 1730383019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A115819) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 245261) |
| 207P00000X Emergency Medicine (Licence: KS 04-35559) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2013-02-26 |