| NPI | 1740714690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 1740714690) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 72458) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-01-22 |