| NPI | 1659548790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023043175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-7226) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2024-09-25 |