| NPI | 1528032208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 38696) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 35913) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-06-29 |