| NPI | 1033593629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E19128) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2024001361) |
| 207P00000X Emergency Medicine (Licence: GA 79977) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2025-05-21 |