| NPI | 1144514902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 324490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 72730) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2021-06-10 |