| NPI | 1346263753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17247) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-11-17 |