| NPI | 1285048363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 10167220-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105214) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2022-07-21 |