| NPI | 1164525036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 54549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015330) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-07-20 |