| NPI | 1275973786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME127802) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301103245) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2022-05-19 |