| NPI | 1114212743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 16843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 199092) |
| Enumeration Date | 2011-06-11 |
| Last Update Date | 2024-06-06 |