| NPI | 1104205467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 71164-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021598) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2024-05-02 |