| NPI | 1275946774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO2366) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021257) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2024-10-29 |