| NPI | 1205909421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-0480) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016198) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-03-15 |