| NPI | 1598751745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 7264) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME59841) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2023-11-17 |