| NPI | 1518499201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85595) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301510309) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-10-27 |