| NPI | 1467989582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R76317) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R76317) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2022-08-22 |