| NPI | 1831148063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 047251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 23639) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2025-01-06 |