| NPI | 1407206188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-49496) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-149264) |
| 207P00000X Emergency Medicine (Licence: WA MD61291931) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2025-02-07 |