| NPI | 1326498585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 328431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT212101) |
| 207P00000X Emergency Medicine (Licence: NH 24337) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-03-28 |