| NPI | 1134589559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 20467) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101263351) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2023-08-31 |