| NPI | 1447479092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C7-0003186) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 44307) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2025-05-29 |