| NPI | 1831397835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M10341) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD183939) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-03-23 |