| NPI | 1306472220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 86158) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL86158) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-03-26 |