| NPI | 1265600498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1404) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS 10155) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2024-10-29 |