| NPI | 1942244090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR C-5537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R6D60) |
| 207P00000X Emergency Medicine (Licence: OK 15999) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-07-28 |