| NPI | 1093242281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301500593) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 304361) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2023-05-17 |