| NPI | 1346635612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 83960) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 83960) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 83960) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2021-03-08 |