| NPI | 1700298429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101277162) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 080073) |
| 207P00000X Emergency Medicine (Licence: IL 036161853) | |
| 207P00000X Emergency Medicine (Licence: FL ME167165) | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2024-03-07 |