| NPI | 1831652189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R77277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A192550) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2024-01-24 |