| NPI | 1932510724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 71776) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 074773) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2023-07-25 |