| NPI | 1235574021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD044067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME155187) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2022-04-29 |