| NPI | 1013265685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 90518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351046149) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2023-08-08 |