| NPI | 1467957951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A165691) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 63242) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-03-14 |