| NPI | 1023469350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 62659) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301110732) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2023-03-29 |