| NPI | 1275701138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301087958) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 253080) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2021-03-09 |