| NPI | 1831400704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD183916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R72190) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2017-10-04 |