| NPI | 1194286880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 20212012603) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 196498) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-10-03 |