| NPI | 1821547225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD044583) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101261247) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-12-26 |