| NPI | 1871796128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 19215) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS10864) |
| 207P00000X Emergency Medicine (Licence: MI 5315022836) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2024-05-06 |