| NPI | 1295185148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 305227) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301511782) |
| 207P00000X Emergency Medicine (Licence: AZ 58148) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2024-04-15 |