| NPI | 1972531374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8115391-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M4339) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2012-03-01 |