| NPI | 1699061465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 17852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301098709) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-10-29 |