| NPI | 1003445503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 009773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R3429) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-02-27 |