| NPI | 1053511527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 43089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301090830) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2023-07-24 |