| NPI | 1285047076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101021138) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 3423) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2023-01-09 |