| NPI | 1457550402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 29834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL29834) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2021-05-27 |