| NPI | 1245725977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021016736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 510123790) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2021-07-28 |