| NPI | 1992048631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 285963) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60864134) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-09-18 |