| NPI | 1740443407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 35347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R70587) |
| 207P00000X Emergency Medicine (Licence: OR MD154407) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-01-24 |