| NPI | 1437844651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 90161) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL90161) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2026-01-21 |