| NPI | 1801029657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-8248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4817) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2022-12-02 |