| NPI | 1124649900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351046001) |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2023-08-09 |