| NPI | 1245850775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A184474) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R77934) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2023-06-15 |