| NPI | 1932290889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 32129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200986) |
| 207P00000X Emergency Medicine (Licence: SC TL32129) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-01-20 |