| NPI | 1942442900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-6678) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012037984) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2012-11-07 |