| NPI | 1073017232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 88589) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151013211) |
| 207P00000X Emergency Medicine (Licence: MI 5101023831) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-04-21 |