| NPI | 1134612641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 22389) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 010060) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: HI 22389) | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2024-05-08 |