| NPI | 1437545514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60879427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 10092262-1205) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-01-13 |