| NPI | 1609227495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 1887) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NE 1887) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2020-06-15 |