| NPI | 1003267782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD191574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301109907) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2019-06-21 |