| NPI | 1235391467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101017660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012003982) |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2023-07-13 |