| NPI | 1598059842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME136109) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 201700806) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2023-07-05 |