| NPI | 1588227466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 66537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R77392) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2023-07-26 |