| NPI | 1942648522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 28510) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 6957) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-04-07 |