| NPI | 1205127115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 71477) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 172732) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2024-06-04 |