| NPI | 1407438229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 72647) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R78584) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-06-26 |