| NPI | 1851581557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 047891) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 54482) |
| 207P00000X Emergency Medicine (Licence: CA G84787) | |
| 207P00000X Emergency Medicine (Licence: GA 47891) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2023-03-08 |