| NPI | 1437391984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-90509) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 006067) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2025-04-09 |