| NPI | 1891922027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 267250-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01069452A) |
| 207P00000X Emergency Medicine (Licence: GA 74988) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2016-05-03 |