| NPI | 1649767534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101275588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MTL004631) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2023-05-03 |