| NPI | 1932542347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME175284) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 61089) |
| 207P00000X Emergency Medicine (Licence: AL MD.41202) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2025-07-22 |