| NPI | 1841930740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 87815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL87815) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2024-06-28 |