| NPI | 1346403268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 19026) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 259522) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-10-29 |