| NPI | 1164502340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101012954) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101012954) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 5101012954) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2024-08-07 |