| NPI | 1740470145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 721-L) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-07-08 |