| NPI | 1063805786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO192831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021574) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2019-07-25 |