| NPI | 1023633666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO217125) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID O-1811) |
| 207P00000X Emergency Medicine (Licence: MI 5151014558) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2023-10-13 |