| NPI | 1013442235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0015841) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 41034) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2022-08-18 |