| NPI | 1780001818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 17176) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 29313) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-07-21 |