| NPI | 1972640472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6671) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO CDR.0003258) |
| 207P00000X Emergency Medicine (Licence: MD T4085) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2024-11-18 |