| NPI | 1386999225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 75883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 57480) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-10-25 |