| NPI | 1821226887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 12280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 6003) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-04-04 |