| NPI | 1013395011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A169116) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD047309) |
| 207P00000X Emergency Medicine (Licence: VA 0101269136) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-06-01 |