| NPI | 1952834046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2020-0257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ NOT AVAILABLE) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-08-31 |