| NPI | 1831503788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60721617) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ r74611) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2023-04-27 |