| NPI | 1841427077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101262581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D74637) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-07-21 |