| NPI | 1578095535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0087984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD047599) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2020-06-17 |