| NPI | 1992230239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-83216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 58568) |
| 207P00000X Emergency Medicine (Licence: AZ R76048) | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-05-01 |