| NPI | 1144560053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 3220) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 510102338) |
| 207P00000X Emergency Medicine (Licence: VA 0102207532) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2022-09-07 |