| NPI | 1639334337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 15712) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0100063) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2024-07-08 |