| NPI | 1710349857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 20025) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD2281) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-10-20 |