| NPI | 1881936300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2023-1086) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 35890) |
| 207P00000X Emergency Medicine (Licence: TX R6578) | |
| 207P00000X Emergency Medicine (Licence: IL 1881936300) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2025-03-20 |