| NPI | 1003345323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 16394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301112415) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2024-05-03 |