| NPI | 1952861791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS18602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 91391) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-06-22 |