| NPI | 1831486232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101257959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD043089) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2021-06-27 |