| NPI | 1861924458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 20129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101266326) |
| 207P00000X Emergency Medicine (Licence: CA A174781) | |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2024-07-23 |