| NPI | 1720240070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-11342) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 252518) |
| 207P00000X Emergency Medicine (Licence: CA A111636) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2023-09-26 |