| NPI | 1659734853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A153362) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD048320) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2020-04-20 |