| NPI | 1316261043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 129449) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 14673) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2023-03-10 |