| NPI | 1174146237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301509119) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301509119) |
| 207L00000X Anesthesiology (Licence: MI 4301509119) | |
| Enumeration Date | 2020-05-24 |
| Last Update Date | 2025-09-19 |