| NPI | 1457766891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2016023068) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 00000000000000000000) |
| 207P00000X Emergency Medicine (Licence: AR E-14758) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2023-01-23 |