| NPI | 1073741823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101018274) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 37710) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2026-01-20 |