| NPI | 1013537216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 23829) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 220972) |
| 207P00000X Emergency Medicine (Licence: AZ 68453) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-05-31 |