| NPI | 1225004310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 56606) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015260) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-12-28 |