| NPI | 1164172714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81923-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015685) |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2025-08-08 |