| NPI | 1750525572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 207P00000X) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2013013932) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2023-09-19 |