| NPI | 1164044673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101027257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014511) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2023-08-03 |