| NPI | 1235558271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 6927) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO Dr.0058214) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2024-03-15 |