| NPI | 1992186878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 30714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7423) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2018-09-23 |