| NPI | 1033210547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301064300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 86469-20) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-10-29 |