| NPI | 1750840070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A20724) |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2024-08-21 |