| NPI | 1124246517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301108982) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI M171178) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-10-12 |