| NPI | 1851929145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2022045946) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-47957) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-11-27 |